Individual provider Active NPI

Kyle Duwayne Klein, D.C.

  • Chiropractor
  • Brigham City, UT
National Provider Identifier
1104911130
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
279675-1202 Issued in UT
Practice address
990 Medical Dr Ste Ul-1
Brigham City, UT 84302-4713
Phone
(435) 723-2311
Fax
(435) 723-9706
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 279675-1202 UT Primary

Addresses

Primary practice location

990 Medical Dr Ste Ul-1
Brigham City, UT 84302-4713

Mailing address

990 Medical Dr Ste Ul-1
Brigham City, UT 84302-4713
Phone (435) 723-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223001274 UT Practitioner - Chiropractic 9234022658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and Family Chiropractic Group PCGroup PAC ID 7517850936, 4 clinicians

Practice addresses (Care Compare)

990 S Medical Dr
Suite Ul 1
Brigham City, UT 84302-4714
Phone (435) 723-2311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
279675-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & Family Chiropractic Group PC Chiropractor CurrentSince Nov 16, 1998 Accepting new patients
Freeland Chiropractic PLLC Chiropractor Past Accepting new patients

Locations

990 Medical Dr
Ste UL1
Brigham City, UT 84302
Phone (435) 723-2311

790 E 700 S
Clearfield, UT 84015
Phone (801) 776-3974

525 S State St
Ste 9
Clearfield, UT 84015
Phone (801) 825-7338

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1104911130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE UL-1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024713",
            "telephone_number": "435-723-2311",
            "fax_number": "435-723-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE UL-1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024713",
            "telephone_number": "435-723-2311",
            "fax_number": "435-723-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "KYLE",
        "middle_name": "DUWAYNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "279675-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.